Larry Summers: The Case for Research

Economist Larry Summers argues that, despite the need to limit government spending overall, health research must remain a top priority.

As Congress wrestles with how to reduce the budget deficit, the future of U.S. federal biomedical funding has been called into question. Proposals before lawmakers urge reductions in the current $31 billion annual budget of the National Institutes of Health, which devotes most of its funds to research grants for scientists at more than 3,000 universities. But cutting federal support would undermine the promise of improved health for Americans, economic growth and innovation, warns Lawrence H. Summers, one of the nation’s leading experts on labor, finance and the economy. He has served in three presidential administrations, most recently as director of the National Economic Council for President Barack Obama, and as president of Harvard University, where he continues to teach. Summers argues that despite the need to limit government spending overall, health research must remain a top priority.

Q: What is the fundamental economic rationale for government funding of biomedical research?

A: The societal return of biomedical research far exceeds the private return. It has been estimated that improved health care had as much impact on increased well-being during the past century as came from all growth in gross domestic product. And yet those expenditures that improved health care represented only a small part of the overall economy, and an even smaller part was devoted to biomedical research.

Q: One criticism of the resources the United States devotes to biomedical research and development is that it’s impossible to measure the impact of that investment because breakthroughs can take decades.

A: It does take time to move from basic understanding of cellular processes to cures for disease. But I suspect an economic revolution will come from progress in the life sciences during the next quarter-century.

Q: What of the complaint that despite spending more on health care as a share of GDP than any other developed nation in the Organisation for Economic Co-operation and Development, the United States ranks 27th in life expectancy in a 40-country study?

A: Americans do lag in life expectancy, but experts think that has more to do with lifestyle and economic inequality than with our inability to provide the best science-based medical care. We lead the world in such care, and that’s demonstrated by the flow of patients from almost every country to the United States when they have critical conditions.

Q: What are the likely consequences of major cuts to federal funding?

A: In coming years, there will be severe pressures on the U.S. federal budget, and projected deficits are large. But we need to take a broader view and think about all of the different deficits. If we were to allow budget pressures to cut NIH funding, the consequences would involve lost employment opportunities for Americans, loss of leadership for America in key scientific areas and missed opportunities for American children to know their grandparents.

Q: Is it possible to measure the impact of research funding in terms of rate of return or other statistics that the private sector uses to evaluate other kinds of investments?

A: Some research hits a gusher, others a dry hole. There’s no rate of return for all research. New jobs, patents, publications, citations and business startups are all ways to make the case, but no individual metric is terribly convincing or accurate. Some of the most important discoveries ever, like those of James Watson and Francis Crick, didn’t lead to any patents and resulted in very few jobs in the short run.

Q: China and South Korea are increasing government investment in science by at least 10% a year. Are you worried that in an increasingly competitive international landscape, the United States could cede its leadership in biomedical R&D?

A: To continue to lead, we first need to make sure American scientists and science itself have adequate resources. That is in doubt. It’s a tragedy that many young investigators can’t get their first grant until they’re in their forties. We’re losing staggering amounts of talent. Second, we need to make sure America is an attractive place for the most brilliant minds from all over the world. That means ensuring that our immigration policies enable talented scientists to study and work here, something that is too often precluded by current policies. Third, we need to establish large-scale platforms for discovery. Growing collaborations among government, industry and academia using platforms such as large-scale gene sequencing will become an increasingly important part of scientific progress.